You're the Real Cost

Spinning health-care reform to the end game

The Regence Group, which sells Blue Cross and Blue Shield health
insurance in Idaho, Washington, Utah and Oregon, has launched a
high-tech political and marketing campaign that the company says helps
people understand health-care reform. But critics say the campaign
places blame on doctors and patients and ignores the role of the
insurance industry in skyrocketing rates, lack of coverage and
administrative waste.

The campaigns, which include a well-designed Flash-based Web site
called whatstherealcost.org*,
television commercials airing on some stations and--making the rounds
on the Web--a new branding headlined "Share the Well" and a fading
Facebook/Twitter push, ask people to take more command over their
health, including challenging doctors and pharmacists.

"The whole goal of this campaign is a consumer education cost
campaign," said Georganne Benjamin, who works in public affairs at
Regence in Boise and helped to design the games on the Web site,
including one called Resist the System. "How you win at that one is by
challenging the system and not just being compliant with what she's
suggesting."

Don McCanne, a senior health policy fellow at Physicians for a
National Health Plan, which advocates for a single public or
quasi-public health insurer, argues that the administrative expenses at
private health insurance companies are the largest wasted cost in the
system.

"How many people do you know that request health care that they know
they don't need but they want to have 'because it's covered?' In over
30 years of my very busy family practice, I cannot recall one single
patient with such a request. Yet the thrust of this Regence Blue Cross
Blue Shield campaign is to blame the patient for requesting too much
health care," McCanne wrote in his daily health-care reform e-mail.

Mike Tatko, media and public relations manger at Regence in
Lewiston, said the company is not playing a blame game.

"It's more of a take charge, take a little bit of personal
responsibility in your life," he said. "We talk a lot about personal
responsibility."

What about responsibility at the company?

"Our administrative costs are about 9 cents on the dollar," Tatko
said. "We'd like to be at 7, we're not there."

Bob Vestal, a retired medical director at the Veterans
Administration Medical Center in Boise and a steering committee
co-chairman at Idaho Health Care for All, PNHP's local affiliate, said
Regence has a point about personal responsibility.

"I think people in this country do need to take more responsibility
for their health and well-being and make good choices," Vestal said.
"There's no way to deny that. On the other hand, what it looks like the
insurance industry is doing is shifting the blame. I think they have
abused their role in the health-care system by creating difficult
challenges for policy holders and making it impossible for some people
to afford and retain health insurance. I continue to ask the question,
'what is the value added that insurance companies bring to the
health-care system?'"

John Geyman, author of Do Not Resuscitate, a book that argues
for dismantling the private insurance industry, said health insurers
say they want reform, but really want universal coverage, or 50 million
new subscribers.

"I think the insurance industry as a whole is trying to posture like
they are reformers and want to help make health care affordable,
control prices and all that but they're a big part of the problem
themselves." Geyman said.